An Ethical Façade? Medical Students' Miscomprehensions of Substituted Judgment
2009

Medical Students' Understanding of Substituted Judgment

Sample size: 29 publication Evidence: low

Author Information

Author(s): Curlin Farr A., Lawrence Ryan E., Fredrickson Julie

Primary Institution: University of Chicago

Hypothesis

How well do first-year medical students understand and apply the concept of substituted judgment after a course on clinical ethics?

Conclusion

Students did not appear to internalize or correctly apply the substituted judgment standard, suggesting it may conflict with their moral intuitions.

Supporting Evidence

  • Students could describe the substituted judgment standard but often misapplied it.
  • Many students expected physicians to balance patient wishes with family desires.
  • Students frequently judged decisions based on outcomes rather than the ethical process.

Takeaway

Medical students learned about a way to make decisions for patients who can't speak for themselves, but they still got confused about how to use it in real life.

Methodology

Students wrote essays on ethically controversial scenarios, which were analyzed for patterns in their understanding of substituted judgment.

Potential Biases

Students may have been influenced by their own moral intuitions and the context of their training.

Limitations

The study is limited by its small sample size and focus on one class at one medical school.

Participant Demographics

First-year medical students at the University of Chicago.

Digital Object Identifier (DOI)

10.1371/journal.pone.0004374

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